NYC-WTC_000208058

NYC 9/11 Public Portal Document

15^=14 PSC Analytical Services 4418 Pottsville Pike PSC Work Order # Readirg, PA 19605 CHAIN OF CUSTODY phone: (610) 921-8333 Page \ of I fax: (610) 921-9667 or 921-8407_________________ PO# Quote St

Report Name JOB ID: Results Mailing Address/IT g- Company X vs. C ________ (^4^ yT fL. ANALYSIS REQUESTED To; City State ZIP r0<?ro Use attachments if necessary. Telephone Please specify method requirements. tS'i. g.3o^ Preservatives Key: Name A = Ascorbic Acid Company Submit C = HCI N2 = NaS2O3 Mailing Address Invoice City 2^ H = HN03 S =H2SO4 ZIP J Stale I = Ice Z = ZnAcetate To: Telephone < Fax# N = NaOH X = None

Sampled by: Credit Card info (include exp. date)

Sampling Location (Specify State); a O=Othai; Due Date: ‘Y (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Presenra/Aes above Key: fist ell th^appt^ UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P^lasfic, G=Glass. A‘Air)

a SAMPLE DESCRIPTION finaJ Air VoJumr Matrix Type Sampling Jnfo Container Volume (Liter. ef<4. (ID must match container labels) . (L ot. rw») Date Time Number i^Conieinera rmfei <:> pfeuj (3l 0 3 /rc-o^/j, - g^p\~VOg-3 /.s > (11- y/ix7 finU bj 4 fiTc-eSr/6> - y OP _______________ 5 fire - A &

o 8 H 9 10 So I—i (1) Relinquished by: Dale Time |n2| Receipted by; Date Time [3) Relinquished by: Dale Time o o I (4) Received by; Date Time l|(5) Relinquished by: Date Time Dale ime o co o o -Z£ Method of Delivery. UPS ED-EX PAS Courier Client US Mail other _______ co

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NYC-WTC_000208058